Everything about pain is an unpleasant experience. When a pain signal reaches the brain, it generates changes in hormones, the state of arousal, the excitatory automatic processes, sensory and motor centers and emotional centers of the brain. The graphic on page 37 of the Neuroplastic Transformation workbook depicts this. When we cannot escape pain because it keeps returning, people lose the expectation of relief and a growing sense of anxiety begins. When the pain is a constant companion, most people experience hopelessness and depression. The overall experience of persistent pain is that of pain unpleasantness, persistence and constancy, mingled with depression and anxiety.

This animation takes the viewer through the intricate relationship between pain and mood. It starts showing the psychological underpinnings and moves to the biological basis for these psychological changes.

This tends to lock in the trauma experienced during the injury, its treatment and recovery. The pain generates overwhelming anxiety, stimulating anatomical pain and emotional centers, releasing excitatory neurotransmitters, activating perpetual nerve firing, releasing more inflammatory substances and placing the peripheral body in a constant state of “red alert.” In a sense the pump is primed for fight and flight and the experience of destabilizing terror is just another increased pain episode away.

We experience anxiety as a feeling of uncomfortableness. It makes us feel uneasy, fearful, unsure and worried. When this is a temporary phenomenon, it can be helpful to warn of danger, but when it becomes chronic, it loses its ability to warn. Like pain it becomes the danger itself. At molecular levels in our brains, this actually causes an inflammatory response in anxiety circuits. Because these circuits share so many common brain regions with pain, chronic anxiety can lead to persistent pain and chronic pain can lead to chronic anxiety. Anxiety becomes the experience that glues pain to us.Be willing to experience the pain to try to gain an understanding of what can be done about it. Once the fear of your pain is brought under control, this becomes a much easier task. Fear is a huge part of what makes pain so intolerable and that fear is built into the experience of pain unpleasantness. Understand that the unpleasantness of your pain is really the combination of a number of events happening in your brain and your peripheral body. Try to tease apart pain from other sensations, but also from your emotions. See if you can determine what you are experiencing in its individual pieces rather than as overwhelming unpleasantness. See if you can bring reason to your emotional responses and calm them down. Try different physical activities and see what hurts and what helps. Avoid anything that hurts until you can work with someone who can tell you if it is all right to move through that pain. Otherwise, see the pain as a way for your body to communicate to you what you should and should not do. Keep looking for ways to get around it, ways to be functional or to restore function. Keep pushing the limits in reasonable increments, while listening to your body for new directions in what to do. Keep trying new ideas that help you take greater control of your pain and your life. Look for things that you can do in the moment, that don’t require any more than minimal equipment and are not invasive in nature. Be as relentless as your pain in finding new activities that reduce it.